Job Description

Responsibilities

Responsible for Managing the Coding and CDI Programs

• Provides strategic direction for Revenue Cycle processes, including Patient Access, charge master description, revenue cycle reporting, charge capture process, denial management, and related functions through quality data, policies, and efficient procedures.
• Maintains competency and knowledge of current standards of practice, trends, and developments in the related scope of the job role or practice.
• Participates in ongoing quality improvement activities.
• Maintains compliance with the organization’s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.
• Identifies opportunities for process improvement and implements them by engaging stakeholders throughout the organization.
• Drives changes in work products and processes that will improve functional area efficiencies and effectiveness.
• Coordinates, motivates, and follows up with all stakeholders and resources to ensure project progress is on schedule and goals and requirements are met.
• Identifies, assesses, and resolves complex business problems/issues/risks and facilitates issue resolution and risk mitigation.
• Works with leadership to assist, define, and document high-level program target dates and projects across a 1-3-year roadmap.
• Guides the project teams through the design, build, and implementation phases of the Revenue Cycle organizational improvements.
• Develops a work plan as defined by the assessment process and benchmark activities.
• Determines/develops business results metrics, models current/future business processes, gathers business requirements, and
• identifies the organizational changes required to successfully realize the benefits of the solution.
• Targets revenue recovery efforts throughout the reporting areas by analyzing problems and implementing solutions.
• Monitors receivables efficiencies, establishes goals, and measures performance.
• Manages and maintains a business relationship with Hospital Management/Revenue Cycle business partners to maximize continued gain-sharing operation.
• Partners with Information Technology and Hospital Revenue Cycle/Financial Operations management for reporting purposes and opportunities awareness.
• Initiates projects focused on improving workflows specific to financial outcomes for increased revenue realization.
• Analyzes Hospital financial reports for opportunities and recommends/implements key indicators and best practices for enhancements, process improvement, or resolutions for increased results.
• Coordinates/Liaisons with hospital business partners and steering committee as well as applies innovative solutions to increase cash and decrease costs.
• Expertise in monitoring efficiencies with Dashboard reporting.
• Leads and manages Revenue Cycle projects, working with key stakeholders.
• Coordinates and implements revenue cycle initiatives, including identifying and assembling resources when necessary.
• Complies with organizational and regulatory policies for handling confidential information.
• Maintains revenue cycle KPIs within established industry standards and instills accountability and ownership at the appropriate level.

Qualifications

QUALIFICATIONS

• Bachelor’s degree in Nursing, Medicine, Allied Health, or any Healthcare field – Preferred
• Healthcare certifications – Preferred
• Coding or CDI certifications mandatory;

Required: Bachelor’s degree in Accounting, Finance, Business Administration, or Healthcare.

Desired: Master’s degree in business administration or healthcare .

One Or More Certifications Required

• CDIP – from AHIMA
• CCDS – from ACDIS
• Any coding certificate approved by AHIMA (e.g., CCS) or AAPC (e.g., CPC).
  

Desired: Healthcare certifications preferred (CHFP, CHAM, CHRI, and/or CMPE).